Enteral nutrition means feeding through the gut. If the gut works but a person cannot eat or swallow enough, a liquid feed can go into the stomach or small bowel instead. Most people know it as tube feeding.
Why it is used
Common reasons include swallowing problems after a stroke or with conditions like motor neurone disease, cancer of the head, neck or gullet and its treatment, a blockage in the gullet or stomach, a stomach that empties too slowly (gastroparesis), and injuries to the face or throat.
Feeds by mouth
Some people can still drink, and are prescribed nourishing drinks to take alongside whatever food they can manage. These are sometimes called sip feeds. Many people on tube feeds can still eat or drink a little too, if it is safe for them.
Feeds through a tube
For a short time, a thin tube can go through the nose and down into the stomach (a nasogastric or NG tube) or into the small bowel (a nasojejunal or NJ tube). For longer term feeding, a tube is placed through the tummy wall into the stomach (a gastrostomy, such as a PEG or RIG) or into the small bowel (a jejunostomy). Some people have a low profile "button" instead of a long tube.
How the feed is given
Feeds can be given with a pump over several hours, by gravity from a bag, or in smaller amounts with a syringe several times a day. Your dietitian works out the right feed, the amount and the timing for you.
Looking after a tube
- Flush the tube with water as you have been shown, before and after feeds and medicines, to stop it blocking.
- Keep the skin around a stoma clean and dry, and watch for redness, swelling, pain or leaking.
- If a gastrostomy tube comes out, contact your team at once, or go to A&E out of hours. The hole can start to close within an hour or two. Do not use it for feeds, and do not try to put a tube back unless you have been trained to. Some teams give you a stoma stopper to keep the hole open.
Remember: your own dietitian and nutrition nurses know your tube. Ask them before changing anything about your feed.